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Abstract: TH-PO708

Urinary N-Terminal Pro-Brain Natriuretic Peptide Is a Useful Biomarker for Cardiovascular Events in a General Japanese population: The Hisayama Study

Session Information

Category: Hypertension and CVD

  • 1401 Hypertension and CVD: Epidemiology, Risk Factors, and Prevention


  • Yamasaki, Keisuke, Kyushu University, Fukuoka, Japan
  • Hata, Jun, Kyushu University, Fukuoka, Japan
  • Hirakawa, Yoichiro, Kyushu University, Fukuoka, Japan
  • Sakata, Satoko, Kyushu University, Fukuoka, Japan
  • Nakano, Toshiaki, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
  • Kitazono, Takanari, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
  • Ninomiya, Toshiharu, Kyushu University, Fukuoka, Japan

Serum N-terminal pro-brain natriuretic peptide (NT-proBNP) levels have been well accepted as an index for estimating cardiovascular risk in general practices. On the other hands, there is a possibility that urinary NT-proBNP is a non-invasive biomarker without requiring blood sampling, because NT-proBNP is excreted in urine. Therefore, the present study investigated the association between urinary NT-proBNP levels and the risk of cardiovascular disease (CVD) in a general Japanese population.


A total of 3,060 community-dwelling Japanese subjects aged ≥40 years without history of CVD were followed up for 8 years (2007-2015). Urinary NT-proBNP levels were divided into four categories using cutoff values of 23, 30, and 42 pg/mL, which were corresponding to guideline-based cutoff values of serum NT-proBNP, being 55, 125, and 300 pg/mL, based on the linear regression analysis of serum and urinary NT-proBNP concentrations (Pearson’s correlation coefficient=0.75). The associations of urinary NT-proBNP levels with the risk of CVD and its subtypes were estimated by the Cox proportional hazards model.


The median value of urinary NT-proBNP concentrations was 20 pg/mL (interquartile range 18-25 pg/mL). During the follow-up period, a total of 170 CVD events developed. The age- and sex-adjusted risk of CVD increased significantly with higher urinary NT-proBNP levels (p for trend <0.001). This association remained significant even after adjustment for conventional cardiovascular risk factors (hazard ratio [95% confidence interval]: 1.00 [reference] for ≤22 pg/mL, 1.13 [0.74–1.71] for 23–29 pg/mL, 1.59 [0.97–2.61] for 30–41 pg/mL, 1.78 [1.11–2.87] for ≥42 pg/mL; p for trend =0.01). A similar association was observed for total stroke (p for trend =0.01), but not for coronary heart disease (p for trend =0.36).


The present finding suggests that elevated urinary NT-proBNP level is a useful biomarker for the development of CVD, especially stroke, independent of conventional risk factors in a general Japanese population.